Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 2901018621 | MI |
Y | 1223P0300X | Periodontist | 2901018621 | MI |
NPI | 1013060052 |
---|---|
Provider Name | Dr. Jacob Steiger |
First Address | Southfield, MI 48075-3246 |
Second Address | Farmington Hills, MI 48331-1588 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2007 |
Last Update Date | 10/09/2014 |